Advocacy and Legal Updates

Medicaid Changes Start to Take Effect
by Artemis Policy Group

As previously reported, a federal law enacted in 2025 (H.R. 1, originally called the One Big Beautiful Bill Act) is starting to dramatically reshape the Medicaid program. On October 1, 2026, new policies went into effect ending eligibility for federally-funded Medicaid and CHIP coverage for certain groups of lawfully present immigrants. (See KFF table reprinted below; for information on state-funded Medicaid and CHIP programs that continue to provide coverage for certain groups of lawfully present immigrants, see this additional KFF resource.) HTCs should note that in families with blended immigration statuses, family members who are U.S. citizens remain eligible for Medicaid/CHIP coverage.

Other major changes to Medicaid eligibility are coming for HTC patients and millions of other Americans when H.R. 1’s “community engagement” [work] requirements go into effect for adults covered under the Medicaid expansion pathway. The Hemophilia Alliance, working with national bleeding disorders partners, has created a toolkit that we hope will help HTCs, chapters, and member organizations understand and explain Medicaid work requirements to the patient communities you serve. The toolkit includes both a comprehensive overview of the new requirements and individual pages or sections that you may wish to use in your communications with patients.